尤瑞克林治疗不同TOAST分型急性脑梗死的临床疗效观察

摘要

目的：评价尤瑞克林治疗不同TOAST分型急性脑梗死的临床疗效。方法采用随机对照设计，将120例急性脑梗死患者，随机分为尤瑞克林组(60例)和对照组(60例)。两组患者均进行TOAST分型，给予基础治疗，尤瑞克林组加用尤瑞克林注射液0.15PNA单位+生理盐水50mL静脉泵入，1次/d，共21d。两组患者均在治疗前后进行神经功能缺损程度评分（NIHSS)。结果两组患者治疗前NIHSS评分无差异(P>0.05)，治疗后NIHSS评分均较治疗前降低（P<0.05）。尤瑞克林组治疗后NIHSS评分低于对照组(P<0.05)。TOAST分型，其中L、S型两组治疗后NIHSS评分均较治疗前降低(P<0.05)；L型尤瑞克林组治疗后NIHSS评分低于对照组(P<0.05)。S型尤瑞克林组治疗后NIHSS评分低于对照组，但差异无统计学意义。临床疗效比较，其中S型两组临床疗效有差异(P<0.05)。计算标准化有效率，尤瑞克林组80.75%高于对照组52.23%。结论TOAST分型中，尤瑞克林能显著改善L、S亚型急性脑梗死患者的神经功能缺损评分，提高临床疗效。%Objective To evaluate the clinical efficacy of Human Urinary Kallikrein in the treatment of acute cerebral infarction (ACI) according to TOAST (The Trial of Org 10172 in Acute Stroke Treatment, TOAST) classification. Methods One hundred and twenty patients with acute cerebral infarction were enrolled in the randomized control trail. These patients were assigned to kallikrein treatment group (n=60)and control group(n=60). They were both treated by identical basis therapy. The patients in the treatment group were treated by syringe pumps of 0.15 PNA kallikrein diluted in 50mL 0.9%saline once daily for 21 consecutive days. The National Institutes of Health Stroke Scale (NIHSS) scores of two groups were analyzed before and after the treatment linking to TOAST classification. Results Before the treatment, the difference of the NIHSS scores between the kallikrein treatment group and the control group has no statistical significance (P>0.05). At the end of treatment, the NIHSS scores in both group are decreased (P<0.05),and the NIHSS scores of the kallikrein treatment group is lower than that of the control group(P<0.05). After the treatment, the NIHSS scores of large-artery atherosclerosis subtype(L) and small-artery occlusion lacunar subtype(S) which are two subtypes of TOAST classification in two group are both decreased (P<0.05). In the L and S subtype, the NIHSS scores of the treatment group is lower than that in the control group.(in the L subtype, P<0.05;in the S subtype, P<0.05). The effective rate in both group of the S subtype is significantly different(P<0.05). The standardization effective rate of the treatment group and the control group is 80.75%,52.23%, respectively. Conclusion Human urinary kallikrein which is safe in clinical use could reduce neurological deficits. And it is an effective treatment against large-artery atherosclerosis(L) subtype and small-artery occlusion lacunar(S) subtype patients of acute cerebral infarction.